Sleep doc says the machine I wanted is ****, do you agree?

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 12:09 pm

Hi all,

I'm 28 with UARS. I just finished my trial with the REMstar Auto. My 90% pressure is 7.5.

My sleep doctor wrote me two scripts, one for a straight CPAP at 8 and the other for an auto at 7-11. In either case, he wants me to come in to learn how to adjust the pressure myself. He told me to get whatever machine I want, then come in for a follow-up to learn how to access all the menus myself.

Because I have UARS and not OSA, my insurance won't cover treatment.

I told him I was most interested in the Puritan Bennett GoodKnight 420E, and he said it's ¢*** and doesn't react fast enough to events. He recommends the Resmed S8 Vantage Autoset if I want an auto, or the M-Series Pro if I want a CPAP, but said I should think it over and decide.

My sleep doctor does have apnea and is board-certified and a full-time sleep doctor, and in general I think he's very good. However, I am wondering if it's more that the 420E didn't work for him, and whether it might be a perfectly good machine for me.

My reasons for preferring the 420E are the availability of software [he supports my wanting software but says the display screens in the M-series are just as good if I use the clinician menus, which he'll teach me to do], the price, and the fact that I've heard people complain that the M-series humidifier doesn't give enough range and sometimes runs out of water when used in very dry climates (and I do live in the desert).

Because my pressure is so low, I don't consider exhale relief to be a "must".

Right now I'm deciding between these:
Respironics M-Series Pro
Respironics M-Series Auto
Puritan-Bennett GoodKnight 420SP (fully data capable CPAP)
Puritan-Bennett GoodKnight 420E (auto)
ResMed S8 AutoSet Vantage (which, being $300 more than the M-Series Auto, is definitely in last place)

I want to get the machine ordered today or tomorrow so I can have it by the end of hte week. Thoughts?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): 420E, respironics, resmed, humidifier, Puritan Bennett, CPAP, auto

DreamStalker · Post by **DreamStalker** » Mon May 21, 2007 12:33 pm

Why is the Respironics "classic" Auto w/ C-flex not in the running?

I would reduce the list by removing the non-auto machines since an auto can be set in CPAP mode quite easily.

You may also wish to consider the HC150 humidifier regarding your HH concerns.

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 1:17 pm

DreamStalker wrote:Why is the Respironics "classic" Auto w/ C-flex not in the running?

Too big and heavy. I live in New Mexico and my family lives on the East Coast, friends on both coasts, my husband's family is in Europe, and we also do a lot of traveling around the state, so *way* too much traveling to make having such a large, heavy machine practical.

Is there some advantage to the REMstar Auto over the M-series Auto that I'm not aware of? Just the humidifier?

cpapernewbie · Post by **cpapernewbie** » Mon May 21, 2007 1:31 pm

The diif of Remstar vs M series: size, humidifier and software

The + of Remstar: no missing data like the M

My M series lost 5 days of data in 1 month.
Sometimes of an 8 hrs sleep - 5 hrs data is mising, only the first 3 hrs is recorded, do not know why

Sine you do not have apnea, you do not really need data recording really so you can even choose a dumb one...

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 1:38 pm

cpapernewbie wrote:Sine you do not have apnea, you do not really need data recording really so you can even choose a dumb one...

Why on Earth would you think that?

Janine · Post by **Janine** » Mon May 21, 2007 2:12 pm

I don't find the classic to be too big. It is so much quieter that it is worth it to me. I travel a fair bit and am buying that one. But it is definitely a personal preference thing.

In case you didn't see this, it is a comparison of the classic and M series.
viewtopic.php?t=19753&highlight=

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Travel

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 2:41 pm

Janine wrote:I don't find the classic to be too big. It is so much quieter that it is worth it to me. I travel a fair bit and am buying that one. But it is definitely a personal preference thing.

In case you didn't see this, it is a comparison of the classic and M series.
viewtopic.php?t=19753&highlight=

Thanks. I'm using the classic now. It's about twice the weight and twice the volume of the M-series, I believe, and I do find it too large and heavy to travel with easily.

Also, supposedly the M-series is quieter? The Respironics site isn't working for me now, but I know the classic auto owner's manual says it's supposed to run at 37dB, and I thought the M-series is supposed to run at 30dB. That post you linked to only compares the M-series Auto to the classic Pro, so (as he says) apples and oranges.

NightHawkeye · Post by **NightHawkeye** » Mon May 21, 2007 2:43 pm

tillymarigold,

The problems folks brought up about the PB420E in the past were noise and premature failure (poor reliability). I suspect that's the basis of your doc's opinion. A year or so ago PB had a real problem with mortality of PB420E's, but I don't recall anyone complaining about it recently. However, even those who complained about the failures also spoke highly of PB's service.

Some of the prolific posters here speak very highly of the PB420E. Because of it's size and weight, I've considered getting one myself, specifically for travel. Good luck.

Regards,
Bill

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 2:55 pm

NightHawkeye wrote:Some of the prolific posters here speak very highly of the PB420E. Because of it's size and weight, I've considered getting one myself, specifically for travel. Good luck.

Thanks for your input! I'm looking for a primary machine, but since I travel a lot and won't be able to afford a second machine for awhile, I want my primary machine to be travel-friendly. (Eventually I want to get one of those tiny straight CPAPs with integrated batteries--I'm not quite clear on whether AEIOMed and Invacare each make one, or whether one of those bought out the other and they're actually the same--so I can take it camping.)

Based on what he said, his objection is actually to the algorithm that detects and responds to events. He thinks it misses events and doesn't respond quickly enough when it detects them. Specifically, he thinks it doesn't respond hardly at all to snores. (Of course, I don't snore, so that's not really a concern for me.)

Having read over posts here, I know that there are also people who felt that the Resmed algorithm (which my sleep doc preferred) didn't respond to their breathing properly, so I'm less concerned.

My main concern now is that, since I'm pretty sure the 420E is the machine for me, I don't want to piss him off! He's a very good doctor and I love how he wants me to be really involved in my therapy, but he also gets angry really easily when he thinks someone is contradicting him. Oh well, qué será, será.

NightHawkeye · Post by **NightHawkeye** » Mon May 21, 2007 3:10 pm

tillymarigold wrote:My main concern now is that, since I'm pretty sure the 420E is the machine for me, I don't want to piss him off! He's a very good doctor and I love how he wants me to be really involved in my therapy, but he also gets angry really easily when he thinks someone is contradicting him. Oh well, qué será, será.

Good luck with that . . ., LOL. With your insight, I'm sure you'll figure out a way to soft-pedal it.

You could provide him with some of the detailed posts from Snoredog and RG about the capabilities of the PB420E and the possible ways to set up the machine. Or maybe he would view that as an assault on his knowledge . . . Just remember, it's you who has to live with whatever machine you get, not him.

Regards,
Bill

tangents · Post by **tangents** » Mon May 21, 2007 3:35 pm

Hi tillymarigold,

I just received my brand spanking new PB420E last Wednesday. I wrote a post about it the next day (5/16/07) - I can't paste the link because my computer can only open one window at a time. There were some good comments in the thread from some other 420E users, and it's anything but technical. It's a really nice machine - I would recommend it so far. I did a lot of reading over the last couple of months, and haven't heard anything bad about the 420E.

Good luck to you,
Cathy

rested gal · Post by **rested gal** » Mon May 21, 2007 3:55 pm

tilly, for a primary autopap machine that can double as the most travel friendly of all (imho), I don't think you can beat the Puritan Bennett 420E autopap. Besides the light weight, its almost square shape and flat surfaces make it the easiest to pack...for me.

I've used almost all the machines you mentioned, including the Invacare Polaris TR. Invacare took over selling the Aeiomed Aura/Headrest machine and renamed it Polaris TR.

I agree with Roberto that if you're going to get a machine at all, it might as well be an autopap since autopaps can always be switched to cpap mode if you want to run a single straight pressure.

"Also, supposedly the M-series is quieter?"
Quieter than the classic REMstars...no, not in my opinion. I have a Respironics REMstar Auto with C-flex. Very quiet - after about 5 months. It was whiny-noisy the first several months but became quiet as a mouse later. Dunno why. I also have a Respironics BiPAP Auto (classic.) Very quiet right from the get-go. Recently I got an M series BiPAP Auto, running at the exact same settings as my "classic" BiPAP Auto. The M makes a very loud revving up whine sound every time I inhale. My classic doesn't make anything like that sound. I hope the M will eventually settle down in sound, but I'm not betting on it. I run a fan in the bedroom, so that pretty much drowns it out.

Some of the differences in sound between any two machines of the same type/same settings can be chalked up to luck of the draw -- whether you were lucky or not in what kind of sound a particular machine makes when it rolls off the manufacturing line. Manufacturers' specs notwithstanding, I don't really think we can say "all of these models are quieter (or noisier) than these later (or earlier) models." Even though the decibels are within the stated specs, the type of sound a machine makes can be annoying, or not, depending on what kind of sound bothers a person.

The amount and type of sound any machine makes is luck of the draw, in my opinion. You could get a noisy 420E (my first one was) or a very quiet one (my second 420E.) Same with an M or any other machine you choose.

elliejose · Post by **elliejose** » Mon May 21, 2007 4:07 pm

The information on my M-series screen is not worth the time it takes to view it. Very very inaccurate!

tillymarigold · Post by **tillymarigold** » Mon May 21, 2007 4:12 pm

Thanks tangents, restedgal, and elliejose,

The post tangents made is here: viewtopic/t20084/Edited-Subject--PB-420 ... -COOL.html in case anyone reads this thread in the future and hasn't seen hers yet.

I do like the quiet-ness of my classic Auto but it's just too big and heavy to make lugging it around practical (for example, I'm cherishing a hope of getting a machine in time to go camping this weekend with some people from church--though my husband and I would probably stay in a hotel since the battery's not in this month's budget). And of course, with a 90% pressure at 7.5, it's not going to be terribly loud anyway!

Restedgal, why did you need to get a second 420E?

Elliejose, are you using the Plus or the Pro?

... I've just thought of another question for the 420E users: does it increase pressure by full cms, or by half-cms the way the classic Auto does? Because as I said, my 90% pressure was 7.5.

rested gal · Post by **rested gal** » Mon May 21, 2007 4:21 pm

tillymarigold wrote: Restedgal, why did you need to get a second 420E?

After a year of good treatment with it, I gave my first 420E away to a friend who had no insurance, was not getting effective treatment with his own older resmed machine, and couldn't afford to buy another machine. He particularly needed one of the advanced settings the 420E has than no other brand of autopap lets you set independently. There was nothing wrong with the machine -- worked fine. Did have that sound I mentioned, but worked fine.

I bought my second 420E as a used machine (at a good deal from another message board person) and still have it. Was happily surprised when I received it at how quiet it was.